Multidomain Lifestyle Intervention Shows Potential to Reverse Early Frailty in Older Finnish Men
Key Highlights:
- Multidomain intervention appeared to increase the likelihood of reversing pre-frailty among older men.
- Improved physical activity was the primary driver of benefit in men.
- Findings suggest lifestyle modification may help slow early frailty progression.
A multidomain lifestyle intervention may help reverse early frailty among older men, according to a secondary analysis published in Annals of Medicine. Using data from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, researchers evaluated whether a comprehensive 2-year lifestyle program could prevent or reverse frailty among community-dwelling older adults at risk for cognitive decline.
The analysis included 1,259 participants aged 60 to 77 years randomized to intervention or control groups. The intervention combined nutritional counseling, structured physical exercise, cognitive training, increased social activity, and management of metabolic and vascular risk factors. Frailty was assessed using a modified Fried phenotype, which includes weight loss, exhaustion, low physical activity, weakness, and slowness. Participants were categorized as non-frail or pre-frail. Multinomial regression models, adjusted for site, sex, chronic disease burden, age, and education, evaluated intervention effects after 24 months.
Study Findings
At baseline, 28% of participants were pre-frail or frail. After 2 years, 30% met criteria for pre-frailty or frailty. Overall, no significant difference in frailty incidence occurred between intervention and control groups. However, a significant three-way interaction between intervention group, baseline frailty status, and sex revealed differential effects.
Among men who were pre-frail or frail at baseline, 45% in the intervention group became non-frail at 24 months compared with 30% in the control group (P = .036). These men were also less likely to remain pre-frail (28% vs 45%; P = .015). Physical activity notably improved among men: those reporting low baseline activity became more active in the intervention group than in the control group (difference of 30 percentage points, P = .038).
Among women, the intervention did not significantly affect frailty status. Women in the intervention group with baseline weight loss were less likely to move to the no-weight-loss group after 2 years (difference of 29 percentage points, P = .006), although the authors noted that this outcome may reflect intentional weight changes related to diet and exercise.
Clinical Implications
According to the study authors, the findings suggest that multidomain lifestyle strategies may help reverse early signs of frailty, particularly physical inactivity, among older men already showing initial frailty components. The authors stated that while effects were modest, lifestyle modification could play an important role in delaying frailty progression in at-risk older adults. The authors also noted several study limitations. For example, the study’s ability to detect changes in frailty was limited by the use of Fried’s criteria in a largely well-functioning population and by the small number of pre-frail and frail participants, which reduced statistical power. In addition, inconsistencies in how weight loss was assessed and the exclusion of individuals with poorer health limit the accuracy and generalizability of the findings.
Expert Commentary
“Modifying lifestyle-related factors may have potential to reverse first signs of frailty among older men. However, the intervention lasted only 2 years, therefore, research with longer follow-up is needed to see possible long-term effects of lifestyle management on the development of frailty,” the researchers concluded.
Reference
Saarela L, Lehtisalo J, Ngandu T, et al. Effects of multidomain lifestyle intervention on frailty among older men and women – a secondary analysis of a randomized clinical trial. Ann Med. 2025;57(1):2446699. doi:10.1080/07853890.2024.2446699